Resistant Hypoglycaemia - A Unique Presentation of Congenital Dengue

Abstract

Vertical transmission of dengue is uncommonly reported. There have been occasional case reports of congenital dengue with thrombocytopenia and myocarditis. This is the first case report of refractory hypoglycaemia in congenital dengue. We are reporting a case of congenital dengue in a primigravida who developed dengue fever in last trimester of pregnancy. She underwent an emergency caesarean section in view of decreased foetal movements. Post-operative she developed post-partum haemorrhage and pleural effusion. Baby was admitted in neonatal intensive care unit in view of respiratory distress and low birth weight. On day 2 of life child developed hypoglycaemia and sudden onset of severe thrombocytopenia requiring glucose infusion and platelet transfusions. Dengue NS1 antigen was positive both in mother and child. Sepsis screen was negative and metabolic profile of the child was normal. The child recovered gradually and was discharged on day 7 of life. Early diagnosis of dengue in pregnancy helps in better management of mother and child. This case also presents hypoglycaemia as a unique manifestation of congenital dengue which nearly lasted for a week.